Pursuit of Happiness

Antidepressants the new age epidemic of drug use

Vishikha Deogawnka

Pursuit of Happiness

Recent advances in the pharmaceutical industry have led to the production of powerful psychoactive medications, which when taken in the manner intended, improve the quality of life of those with specific medical conditions, such as acute pain, epilepsy, dependence on opioids, acute anxiety, etc. However, when used inappropriately, these medications can have serious consequences for health and can lead to dependence. According to the World Drug Report, the misuse of prescription drugs, is a growing health problem.

With the growing accessibility, availability and acceptance of the use of prescription drugs, a “pill-popping culture”, where daily life occurrences are seen as problems and coped with by misusing medication, is becoming more common in the United States and there are concerns that the non-medical use of prescription drugs will also become a cultural norm in other countries. Distinguishing between real cases of patients who need treatment for a medical condition (for example, chronic non-malignant pain) and those who are pressuring for a prescription for other reasons is difficult and professionals often receive very little training in this area.Self-medication can be very difficult to detect by health professionals or family members, because patients who misuse their medication in this way often do not report their usage. Studies show that persons who begin using prescription drugs non-medically at an early age are more likely to be diagnosed as having a lifetime dependence on them.A large single dose of an opioid could cause severe respiratory depression that can lead to death, while long-term use can lead to physical dependence and addiction. When psychoactive prescription drugs are taken for a sustained period, tolerance can develop, which leads to a need to take larger doses to maintain the same effects. Continued use can lead to physical dependence as a physiological adaptation to the regular use of a drug. Further, non-medical use of prescription drugs has been associated with crime. Property crime, drug dealing, violence, intoxicated driving, uninhibited and aggressive behaviour have been attributed in particular to the non-medical use of benzodiazepines.

Pursuit of Happiness
Thus, several measures have been taken to combat this new-age, self-induced epidemic. The United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances (adopted in 1988), includes legislative and administrative measures against drug trafficking. According to the United States Drug Abuse Warning Network (The DAWN Report, June 2010), data for 2004-2008 show that the estimated number of emergency department visits involving narcotic pain relievers rose from 144,644 in 2004 to 305,885 in 2008. Data for Australia shows a similar trend. Hospitalizations in Australia due to poisoning from opioids other than heroin increased from 32.6 per cent in 1999 to 80.3 per cent in 2008 (AIHW National Hospital Morbidity Database, from 1998-1999 to 2007-2008). The Single Convention on Narcotic Drugs of 1961 as amended by the 1972 Protocol, established the control and use of psychotropic substances. The Convention on Psychotropic Substances of 1971, established an international system for the control of psychotropic substances. The substances controlled under the 1961 Convention comprise plant-based drugs, such as opium, morphine, codeine, cannabis and cocaine; and synthetic drugs, such as methadone and pethidine. The substances controlled under the 1971 Convention are stimulants (such as amphetamines, methylphenidate and phentermine), and sedative hypnotics/anxiolytics (such as barbiturates and benzodiazepines).

Most people will encounter prescription drugs throughout their lives, because they are not substances to be avoided like illicit drugs, but are a part of everyday life and can improve quality of life for many people when they are used appropriately for their medical purpose. Hence it is of utmost importance that measures be taken to safeguard patients from misusing their medication.

Some measures include-

  • • Promoting simple safety measures about how to store prescription drugs safely, raising awareness about the dangers of providing their children with prescription drugs that have not been prescribed for them, and monitoring their child’s use of prescription drugs for medical or non-medical purposes;

  • • Establishing a medication management system that ensures that medication is available to those who need it, while monitoring for and preventing possible diversion at all different levels: production, storage, health-care (prescribing physicians and pharmacists), patients, and the Internet;

  • • Raising awareness among policymakers and clinicians, parents, young people, and teachers;

  • • Training health-care professionals on an ongoing basis on how to prevent, recognize and manage the non-medical use of prescription drugs and related consequences;

  • • Researching whether and how-to tailor prevention and treatment efforts for the non-medical use of prescription drugs; the risk and protective factors for the non-medical use of prescription drugs, with particular attention to specific risk populations, such as young people, women, older adults and health professionals;

  • • Providing clear guidelines to physicians on good practices for prescribing the use of strong psychoactive medication, including both initiation and time limits.